It is a zoonotic disease circulating mainly among small animals and their fleas caused by Yersinia pestis bacteria (G-ve cocco-bacillus belongs to enterobacterecea) which rarely infects humans.
-Modes of Transmission:
It is transmitted between animals and humans by:
· Infected flea bite à bubonic plague
· Direct contact à septicaemic plague
· Inhalation à pneumonic plague
· Ingestion of infective materials (rare) à septicaemic plague
1-3 days (pneumonic) or 2-6 days (bubonic)
1- Always begin by "flu like symptoms":
- General malaise
· High fever (hyperpyrexia) and Chills
· Headache and Body aches
· Nausea and Vomiting
2- Develop one of the "3 forms" according to the route of infection:
Bubonic plague: (the most common) Septicaemic plague Pneumonic plague: (the most virulent and least common)
-Complications: mainly to bubonic and septicaemic forms:
· Meningitis and Convulsions
· Endotoxic Shock (a cause of death)
· Septic Shock from sever pneumonic form (a cause of death)
Rapid treatment is critical for survival as: (within 24 hrs)
*Without Treatment, fatality rates: up to 90% for bubonic plague, 100% for septicaemic or pneumonic plague.
*With Treatment, fatality rate= 5-20%.Drugs used: Streptomycin is the drug of choice; then Gentamycin, Doxycycline and Ciprofloxacin; but ß-lactams are not useful + Supportive treatment as O2, IV fluids, Respiratory support …etc.
*For Full Text --> download from:Plague.pdf